The Design, Implementation and Evaluation of a Physiotherapist Led Clinic for Ortho Surveillance for Children with CP

The aim of this study was to describe the development process and the evaluation results of a new physiotherapy-led clinic for orthopedic monitoring of secondary impairments for children with cerebral palsy (CP).

A new clinic model was developed and implemented, guided by the Framework for the Development of Advanced Practice Roles and the Model for Improvement. Patient visits and wait-time statistics were measured during the implementation phase. Once implemented, an evaluation of the clinic model objectives was conducted. The Visit Specific Satisfaction (VSQ-9) Instrument and the Measure of Processes of Care (MPOC-20) questionnaire measured parent satisfaction, while the Collaboration and Satisfaction about Care Decisions (CSACD) surveyed staff’s satisfaction. Means and frequencies described the data, and the Mann-Wittney U test was used to compare the VSQ-9 and MPOC-20 scores of the physiotherapist-led and the traditional physician-led model.

Ninety-eight additional children were seen in 1 year. Mean wait time decreased by 930 days. No statistically significant difference was demonstrated in the VSQ-9 total score (p = .84) or any of the five MPOC-20 subscales (Enabling and Partnership: p = .55; Providing General Information: p = .99; Providing Specific Information: p = .46; Coordinated and Comprehensive Care for the Child and Family: p = .33; Respective and Supportive Care: p = .86) when the two models were compared. Physiotherapist-led clinic staff members were satisfied with physician collaboration.

A physiotherapist-led clinic model for orthopedic monitoring provides increased access to service for children with CP and their families without compromising the perceived quality of care.